Provider Demographics
NPI:1851532774
Name:FIELDS, YOLANDA G
Entity Type:Individual
Prefix:
First Name:YOLANDA
Middle Name:G
Last Name:FIELDS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4009 FITZHUGH AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-3953
Mailing Address - Country:US
Mailing Address - Phone:804-447-5240
Mailing Address - Fax:804-447-5241
Practice Address - Street 1:4009 FITZHUGH AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-3953
Practice Address - Country:US
Practice Address - Phone:804-447-5240
Practice Address - Fax:804-447-5241
Is Sole Proprietor?:No
Enumeration Date:2009-03-24
Last Update Date:2009-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225X00000X
VA2202001735235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA2202001735OtherVIRGINIA DEPARTMENT OF HEALTH PROFESSIONS STATE LICENSE
VA2202001735OtherVIRGINIA DEPARTMENT OF HEALTH PROFESSIONS STATE LICENSE
VA2202001735OtherVIRGINIA DEPARTMENT OF HEALTH PROFESSIONS STATE LICENSE